Bailey’s Irish Cream – an update

Turns out my post from last year on Bailey’s Irish Cream is my top viewed post. So for the sake of my curiousity, I thought I’d revisit the topic to see if Bailey’s is/was still off limits.

Courtesy of their “Product and Company Information” page, we get this gem:

So for the time being, it looks like Bailey’s is currently gluten free.  However, I really wish our various food, beverage and alcohol groups/advisory boards/congressional groups would get with the program.  Make alcohol producers put ingredient labels on their products, just like for every other product we consume.  And I really wish companies would cut the shit out with the ‘consult a medical professional’ bullshit.  How the hell is my doctor going to know what is in your product when I don’t?  This line in particular galls me: “Your doctor can then contact us for a more detailed list of component ingredients if required.”  I should be able to hold a consumable product and know what is in it.  Neither I, nor my doctor, should have to contact anyone to know what is an a product that is meant for human consumption.

Gearing up for a gluten challenge

I know I haven’t been around much lately.  I haven’t had much I’ve felt like writing.  And I’m trying to get both some school and personal projects done (I’ve yet to be successful with those either).

But one thing I did discuss with my doctor the last time I saw her was the possibility of doing a gluten challenge so that I can finally get diagnosed with celiac disease.  It’s been hard to really work through why I really want a celiac diagnosis.  There is a little voice that lives in the back of my head that questions this whole gluten free thing.  Wonders if I really need to do it.  Wonders if a little wouldn’t hurt.  I’d like to attempt to quiet that voice.  Since my dad is diagnosed as celiac, and I fit two out of the five criteria for having celiac disease, I likely have it too.  Now to make it official.

The hard part however has been scheduling when to do this gluten challenge, as I’m sure it will impact my ability to function, and answering the question of just how much gluten I need to eat for how long to get an accurate diagnosis.  On this last one, the doctor and I didn’t agree.  She said to eat “some” every day for two weeks, and then come in for the blood work.  That set off warning bells in my head, so off I went in search of papers on the subject.

So far, there is only one paper that addresses this question specifically:

Pyle G. G., B. Paaso, B. E. Anderson, D. Allen, T. Marti, C. Khosla, and G. M. Gray. 2005. Low-dose gluten challenge in celiac sprue: malabsorptive and antibody responses. Clinical gastroenterology and hepatology 3:679-86.

pubmed link

The gist is that 8 diagnosed nonsymptomatic celiac patients ate gluten daily for 21 days.  Four of them had 5 g a day, the other four had 10 g a day.  While all the patients had an increase in symptoms and all the patients performed worse on a few of the malabsorptive tests (which aren’t incredibly accurate), NO ONEs antibody levels changed.

So I’m still left wondering how to handle this.  This paper was helpful in that I know 10 g a day for 21 days is insufficient.  But I don’t know if I’ll just need to eat more or longer, likely both.  And as 10 g is roughly equal to two slices a day, I’ll definitely be blowing that portion right out the water, as I plan on consuming gluten like a ‘normal’ person, at pretty much every damn meal.  Now the question is for how long will I need to suffer?  And hope that this will all be worth it in the end.

New to me ciders

Beer tour 2011, I mean, Family tour 2011, wrapped up last week and I came back with TEN new to me ciders to try.

While there are 11 bottles in this picture, I’ve had the Woodchuck special reserve before (all 12 bottles of it :) But of the others, I had never seen them. So into our bottle collection in the trunk they went.

So far, I’ve tried the Peach Hard Cider from Bean Blossom Hard Cider made by Oliver’s Winery in IN. The cider was incredibly light and fruity, more peach cider to me than apple cider with peaches. Would I buy it again? Unlikely. Am I glad I tried it? Certainly. And now I’ve got the funky bottle to show for it.

Look forward to a few more reviews. I’m not sure I’ll review them all, but hopefully I remember to post about the notable ones.

Peach Salsa

I went a salsa canning kick earlier this week. Unlike the 10 lbs of tomatoes I bought 2 weeks ago for $2.50, these 10 lbs (this time for $5) actually got almost all used BEFORE I had to cut off large chunks due to stupid fungus.

I’m going to make these recipes VERY bare bones. If you know how to can, these are all canning safe recipes. If you like fresh salsa, these all work fresh. If you’d like to learn to can, I suggest reading something like this pdf from the University of Wisconsin Extension office. Canning is doable, with patience and the right equipment, but you really need to be prepared. I don’t want anyone blaming me for a case of botulism because they tried canning these recipes and didn’t know what they were doing.

There are three recipes. I’ll post them in order of what I liked best. I also halved all the original recipes, as I wanted variety more than volume. If we weren’t leaving Tuesday, I’d contemplate getting more tomatoes to make of the first of these two salsas.

Peach Apple Salsa
This recipe is also from that pdf I linked above. It’s *almost* like Trader Joe’s peach salsa, which is by far my favorite store bought salsa.

1. You’ll want to make sure your apples and peaches don’t brown. You want to end up with
5 c peeled diced unripe peaches
1 c chopped granny smith apple
Into 8 cups of water, add 1500 mg of vitamin C (ascorbic acid). If you don’t have vitamin C tablets like I don’t, you might be able to find this in pure powder form at your local health foods store (Willy St Coop had it). In that case you’ll use about 1/2 tsp of the powder to the 8 cups of water. Wash and peel your apple(s) (1 large) and peaches (4 for me). Chop them in half and add to the vitamin C water. Soak for 10 minutes.

2. Combine in a large pan:
3 cups of peeled diced tomatoes (they suggest roma, that isn’t what I had)
1.25 c diced yellow onion
1 c chopped green bell pepper
2T pickling spice (tie into a reusable tea bag, mesh bag, cheese clothe, whatever works for you)
1.5t canning salt
2 t crushed red pepper flakes
1.875 c (so 1.5 c + 1/4 c + 1/8 c) packed light brown sugar
1 1/8 c cider vinegar (must be 5%)
5 c peeled diced unripe peaches (from step 1)
1 c chopped granny smith apple (from step 1)

3. Bring to a boil, stirring, reduce heat and simmer for 30 minutes, stirring occasionally.

4. Remove spice bag.

5. At this point it is edible. But if you want to can it:
you’ll need to put the solids in first to 1.25 inch headspace, then stop with cooking liquid to 1/2 headspace. Do your canning clean up and process cans for 15 minutes at sea level.

If you really want to can this, and want all the more nitty gritty directions, read the pdf link. Seriously. But if you have experience canning, I don’t imagine this will be difficult at all for you. It’s quite tasty.

Chicken/pork rub

Oh look, two recipes in one day! (you might even see a third if I am up for it)

This recipe is by far the one I’ve used the most in the past two weeks. I got the base somewhere off allrecipes and then mangled it to be ours. And honestly, I haven’t made it the same way twice. Every time I use it, I change something. Every version has been stellar. All the spices here are dried.

Chicken/Pork rub
Combine in a small bowl:
1/8-1/4 c brown sugar (the original was 1/4, 1/8 works too, more is better if you have more meat)
1 tsp basil
1 tsp garlic salt
1 tsp thyme
1/2 tsp chili powder
1/4 tsp cayenne pepper
1 Tbsp olive oil

Mash around with a fork and then rub onto your meat of choice. Cook as desired.

More specifically how I’ve used it:
-Two large pork steaks, slathered on both sides, cooked under the broiler for 7 min a side (a bit too long in our opinion)
-4 chicken quarters, baked at 350-400F for 45 or so minutes, until the chicken was done, or with 6 quarters.
-I’ve also put rosemary in. And sage. I forget the cayenne last time. You could do the garlic and salt separate. The original had 1.5 tsp of basil.
Etc.

My mom’s tomato sauce

I discovered the cookbook section of the university library that is across from my building on campus. This could be bad. Really bad. Or really tasty.

This recipe is truly my mom’s recipe, and her mom’s recipe. I did not grow up eating tomato sauce from a jar. While my mom always used canned whole tomatoes, the sauce was always made by her. You can certainly use canned tomatoes in this recipe, or fresh as I’ve attempted to detail below. If you find the sauce too thin, or not tomato-y enough after cooking down, I suggest adding tomato paste until you get it to how you like it.

My mom’s tomato sauce
1. In a medium soup/stock pot combine:
-About a half a pot worth of roughly chopped tomatoes (roughly 3 28oz cans), mine looks like about 6 cups, I’ve honestly never measured.
-1 tsp salt
-1 tsp oregano
-1 Tbsp sugar

2. Bring to a boil and reduce to simmering. Simmer for 1-2 hours.
3. Put through a food mill to get out all of the skin and seeds.
4. If you still aren’t satisfied with the thickness of the sauce, continue to cook it down some more.
5. If the taste isn’t quite there for you, add some more of what you think it needs, and simmer just a bit more.
6. This sauce can certainly be used fresh. It also freezes well. Unless you REALLY know what you are doing, I don’t suggest canning this recipe, as I have no clue if the acidity level meets any of the guidelines for canning.

In hindsight, this recipe works much better as a conversation than a list of instructions. There are so many variables here. Have fewer tomatoes? More? It will still work, you just need to adjust. Really like other spices in your sauce? Have at it. Prefer it sweeter? Etc. This sauce is VERY easy to modify.

Cherry Ice Pops

This is the second time I’ve made these cherry ice pops. I’ve upped the sugar and the vanilla and I like them even more this go around than the first. If I’m not careful, I’ll eat the rest of these tonight. I’ve already had 2. And this last batch only made 4. Who knew I could down a cup of cherries in one day?

Cherry Ice Pops
In a blender or food processor combine:
2 cups pitted cherries
2-4 T sugar (I used 3 this last time and it was perfect for me)
2 t lemon juice
2-4 t vanilla extract (I wanted to use 4, but I got distracted, so I might have used 3)

Blend/process.
Pour/spoon into ice pop molds.
I bought these ice pop molds a few months ago and they are turning out to be my favorite.

Yellow gluten free cake in a cup

If something here doesn’t make sense, please ask. I’m tired. But for whatever reason, resisting going to bed. There weren’t too many versions of this online that actually looked good that I’m not going to link to any of them. But I did have an ‘ah ha’ moment when I remembered this post from Gluten Free Gobsmacked the other day. Ratios. I’m not crazy keen on the idea of baking my ratios. I’m sure it works better. I’ve got other things that are more important to me. And sifting and weighing my flours does not fall on that list. So I modded her recipe the best I could, basing it on what I’d see in some gluten-containing cake in cup recipes, and came up with the below. This was much better than my first attempt which is currently sitting in the melted garbage bag in the trash can (yes, I super cooked it so much {it didn’t look like it was cooking right?!?} that five min after taking it out of the microwave, it was still bubbling hot and melted the garbage bag when I put it in the trash, oh well). I may have overcooked this a bit, so be careful of the cooking times. But the taste was good and it’s all gone. I liked this much better than the chocolate cake in a cup that I made a while back. So much for low carb.

Gluten free yellow cake in a cup
1. Melt 4 T of butter in a large mug.
2. Add 4 T sugar and mix well.
3. Add one large egg and whisk as best you can with a fork.
4. Add 1/2 t vanilla.
5. Add the following flours, one or so at a time:
1 T potato starch
1 T brown rice flour
2 T sweet rice flour
2 T white rice flour
Mix well between each addition.
6. Add 1/8 t baking powder and a pinch of salt. Mix well.
7. Microwave in bursts, assessing how done your cake is between each. Each microwave cooks different, and I’m sure the mug you use will also affect timing. Mine was something like 45 seconds, 45s, 25s. I do wish after the first microwaving that I’d added chocolate chips in (not at the start, because they’ll just all sink). But I forgot. So after I turned the cake out into a bowl I just sprinkled on chocolate chips. Either way, it’s all gone now and I’m feeling guilty for the amount of refined carbs I just ate.

recipes in the works, and green beans

I’ve made a few things recently that I want to post, but I don’t want to post them until I’ve actually eaten them. I made maraschino cherries the other night. But they need to soak for two weeks, ideally. I might hold out to next week and then see how they taste. I also made dill pickles out of cucumbers from my own garden. But those also need two weeks. And just now I made some orange cream ice pops. But those will need to freeze over night. So hopefully soon I’ll have some new exciting recipes for you. In the mean time, green beans are in season. Here’s what I made with a few handfuls tonight for dinner.

Easy green beans
1. Put a pot of water on to boil with enough room to fit your green beans in.
2. While the water is heating up, rinse and cut the ends off your green beans. If you’ve got a newer cultivar (and if you don’t know, you likely do have a newer cultivar), you shouldn’t have to destring them. If you’ve got an older cultivar, you might need to destring them.
3. When the water is boiling, drop the green beans into the water and blanch for 6ish minutes. More or less depending on how cooked or crunchy you like your green beans.
4. While the green beans are cooking, chop up one to two cloves of garlic and a few sprigs of fresh dill. Mince them together.
5. When the beans are done, remove them either with a slotted spoon or use a colander.
6. In a bowl combine the hot beans, one to two tablespoons of butter, your garlic/dill mince, and a few shakes of salt. Mix well and serve.

500 Fruits update

I’m well past due for a fruit update. While I did get a few more fruits while I was in Costa Rica this year, and a few that I’d call slightly exotic, my list didn’t grow as much as I would have liked. All well. I’m now more than 1/5 done! Of the recently added fruits, mamonesare by far my favorite addition. Kids generally aren’t allowed to eat these as they do pose a chocking hazard, but boy are they tasty. The tamarind, not so much. Here’s the updated list, in alphabetical rather than numerical order.

39 Africot, Black Velvet
91 apple, ambrosia
82 apple, arkansas black
67 apple, cortland
64 apple, crab
92 apple, granny smith
81 apple, haralson
72 apple, honey crisp
80 apple, northern spy (2011)
65 apple, paula red
101 apple, water
61 apple, WI gala
87 apple, winesap
14 Apricot
26 Asian pear
17 Avocado
6 Banana
44 banana, red
31 Blackberries
18 Blueberries
58 cactus fruit
29 Cantaloupe
46 cherries, dark sweet
28 cherries, Rainier
38 cherries, sweet red
37 Clementine
77 cranberry
70 date, medjool
51 eggplant
56 gooseberries
104 granadilla
98 grape, muscat
32 Grapefruit
50 grapes, black
55 grapes, concord
20 grapes, green seedless
10 Grapes, seedless red
5 Guanabana
7 kiwifruit
84 kumquats
52 lemon
78 lemon, meyer
100 lemon, orange, CR
34 lime
42 lychee nuts
102 mamones
62 mandarin, daisy
89 mandarin, gold nugget
96 mandarin, royal
2 Mango
60 mango-nectarine
110 melon, galia
109 melon, honeydew orange flesh
53 melon, horn
47 melon, sprite
36 mulberries
103 nance
15 Nectarine
41 nectarine, white
106 noni
83 orange, blood
90 orange, moro
12 orange, navel
4 Papaya
9 passion fruit
11 Peach
54 peach, donut
99 pear, abate fetel
43 pear, bartlett
86 pear, bosc
88 pear, comice
24 pear, D’anjou
108 pear, forelle
76 pear, Harrow’s delight
85 pear, luscious
30 pear, Packham’s Triumph
27 Pear, red Anjou
73 pear, seckel
63 pear, star krimson
107 pear, taylor gold
71 pear, tosca
97 pear, ya
113 peas, snow
112 peas, sugar snap
25 pepper, bell (red)
33 pepper, jalapeno
74 persimmon
35 pineapple
22 plum, black
48 plum, dapple dandy
66 plum, egg
3 Plum, purple
21 Plum, red
45 plum, yellow
23 Pluot
40 Pluot, Red Velvet
75 pomegranate
59 prune plum
95 pummelo
79 quince
13 Raspberries
57 star fruit
8 strawberries
111 string bean, purple
105 tamarind
94 tangerine, murcott
93 tangerine, pixie
19 tomato, grape
69 tomato, heirloom
68 tomato, roma
16 tomato, vine on
1 Watermelon (May, 2010)
49 zucchini

Sauteed sugar snap/snow peas with carrots and honey glaze

This is an incredibly easy dish, but takes longer then I think it should. But it’s an easy summer side dish using mostly seasonal produce.

Sauteed sugar snap/snow peas with carrots and honey glaze

1. Cut about 2-4 lb of carrots into a shape and width that roughly resembles your pea pods.
2. Steam them over boiling water for about 3-5 min. More if you like your carrots mushier, less if you like them crunchier.
3. While the carrots are steaming, washing and remove the strings from 0.5-1 lb of pea pods (the original recipe calls for sugar snap peas, the snow peas also looked last week, so I used both).
4. Melt 1-2 T of bacon fat (or butter) in a large skillet. Here is a place that I would actually recommend a nonstick skillet, but a well cured cast iron will work well too. Saute pea pods for about 5 minutes.
5. Drain and add the carrots to the peas, cooking for another 3 min or so.
6. Add 1-2 T honey, depending on how many carrots/peas went into the skillet, and how sweet you like things. Cook for another minute or so, stirring regularly.
7. Turn off the heat, add 1/2 tsp thyme, and salt and pepper to taste. Serve!

Iced ginger chai

I’m not too sure how Rascal is doing. His blood work came back better last week. His initial eosinophil count was 17 X10^3, the normal range is 0-2 x10^3. It came back at 4 last week. So whatever we did, or whatever his body is doing for itself, is helping. but he had a major vomiting session last night, and has been lethargic today, so that has me really worried. I’m really hoping this is not the beginning of the digestive issues if he does indeed have hypereosinophilic syndrome (which I’m going to start calling HES in writing). At this point, I’m taking it one day at a time. If he doesn’t have HES, then it likely isn’t too serious, and his treatment will stay the same. He’ll die one day either way. If he does have HES, this treatment will stay the same, and he’ll just die sooner rather than later. I’m coming to accept that we’re really doing everything for him that we can and that that is good enough.

[Iced ginger chai](http://www.elanaspantry.com/iced-ginger-chai/). Something happier to think about. I’m almost hesitant to repost this recipe, since it’s pretty easy and I hate even the prospect of plagiarizing someone else’s work. But this is one of those recipes that I’m afraid will disappear one day. So I want my own copy.

I love reading [elena's pantry](http://www.elanaspantry.com/), but I don’t often make much of what she posts. We’ll chalk it up to laziness. I’m glad I wasn’t lazy with this recipe. I made a half batch Saturday. And drank it all on Sunday. Last night I made a full batch. I don’t see it lasting more than a few days.

Iced Ginger Chai
There are many variants on chai, so if you like this play around with it and make it really your own.

1. In a large pot (one where you have room for your concoction to boil) combine:
8 cups of water
1/2 cup chopped fresh ginger, I too left the skin on
10 pods cardamon
5 whole cloves
10 whole black peppercorns
1/2 teaspoon fennel seed (I despise fennel, but here I can’t taste it, win!)
1/4 cup loose rooibos tea (or black if you want the caffeine)

2. Bring it all to a boil and let it simmer for 30 minutes, you want it to reduce some.
3. Turn off the heat and cover and let sit overnight.
4. Strain the next day and store in the fridge. This is now your chai concentrate.

To serve: Add some ice to a glass, pour in about a cup of chai concentrate, and top with almond milk. I’ve been making mine in small mason jars so that I can put all three in together and just shake it up. I’ve put heavy cream in too with the almond milk, and that tastes fabulous.

I sweetened mine with honey. What I did figure out with the first batch is that honey doesn’t like to dissolve in a cold liquid (duh). So this time after I strained it, I put some of the liquid back in the pot, added honey, and heated the whole thing up to get the honey to dissolve and then added that back in with the rest of the concentrate. If you do it this way, you’ll have to play around with figuring out how much to add, as I didn’t measure how much honey I put in.

Ideas for what to try next time (taken from the comments on elana’s pantry):
-use four black tea bags (Darjeeling, Assam, oolong)
-add a stick of ginger
-add a star of anise

Sweet and hot pepper dip

The ManBeast and I were at Brennan’s Friday. The great thing about Brennan’s is all the samples they put out. I tried everything that appeared to be gluten free. But the one thing that stuck out in the ManBeast’s and my memory was the sweet and hot pepper dip. But at $8 for a tub, neither of us were willing to splurge. Between upcoming vet bills, my car needing some work, and a gum surgery I should really schedule already, money is (and will be) tight. But the ingredient list was pretty simple so I figured I’d try to make it myself. And I think I’ve just about got it.

Sweet and hot pepper dip
In a small food processor bowl combine
-1/2 package cream cheese
-1 T sweet pepper relish
-1 T hot pepper relish
-2 t siracha
-1/4 t chili flakes
Combine well. If it seems too thick, add maybe a teaspoon or so of milk.

In hindsight, the hot pepper relish we found isn’t hot at all. I probably could have just bought one bottle of the sweet. I was about to add another teaspoon of siracha when the ManBeast suggested that we’d get more heat quicker out of the chili flakes, and that is exactly what happened. If you don’t likely spicy, what I’d suggest doing is leaving out the siracha and chili flakes, mix the cream cheese and pepper relish, THEN start adding the spicier things. This way you’ll have more control over how spicy it is. If you like spicy food, obviously you’ll want to add more of either the siracha or the chili flakes. I’m currently enjoying my creation with corn chips.

cats and love

Note: I started writing this last Friday night. I’ve decided to leave what I wrote, and just do my best to wrap it up in the present.

Oh the things we do for those we love. This post finds me sitting on the floor of our tiny bathroom hoping my cat will eat the expensive food mix I’ve put out for him. Rascal had at least one seizure last week that we know of for sure (now actually two weeks ago). But he likely had at least two more. I talked to the vet after the first one and she said just to keep an eye on him. So after the third one she asked that I bring him in. She did blood work telling me it was unlikely that she would find anything. But she did. Sky high eosinophil numbers. Between that and the seizures, her tentative diagnosis is hypereosinophilic syndrome. Very rare, very progressive, and very deadly.

So now here we are, two weeks out from the first seizure, and Rascal is about to become the $5000 cat (at least) instead of the $4000 cat. And he might be dead in a few months any way. This morning we had an appointment with an internal medicine specialist to start additional testing. Hypereosinophilic syndrome is a diagnosis of exclusion. First you have to rule out anything else that might be causing elevated eosinophil levels, such as parasite infections, allergies or leukemia. Then you have to look for additional hints that it could be hypereosinophilic syndrome, such as eosinophil infiltration into the organs.

So now Rascal is on twice daily prednisone, his food is being switched to hypoallergenic food, and he was given a treatment of Revolution last week. This morning blood was drawn to test him for toxo, crypto, and heart worm. Assuming those all come back negative tomorrow, he has an appointment next Tue for chest xrays and ultrasound along with taking samples from his kidneys and spleen. This should look at whether he has eosinophil infiltration into his organs and look for swollen organs (another sign of organ infiltration). After that, I’m not sure what.

There is the chance we don’t figure out anything. And there is also the chance that I get home today and he’s dead. So it’s been an emotional past two weeks.

I do have food updates to do one day soon. I’ve got an update on my fruit list, and some fun food adventures in Costa Rica. I’ve also got a few recipes to share with you all. Soon.

Is gluten intolerance real?

If you are around the alternative health blogs at all, or really many mainstream health sources these days, you might have seen mention that ‘perhaps a gluten free diet can help you too!’ But if you don’t have celiac disease, is going gluten free of any use? Are there gluten issues other than celiac disease and a true gluten allergy? Is gluten and wheat intolerance real? What I think this really gets to is, if we don’t medically understand something yet, is it real? I’ve heard many people argue that gluten intolerance simply isn’t real. Either you have celiac disease or you don’t. It’s not a stance I agreed with, especially after reading this article.

All I know is, some people do report that they feel better when they eat gluten free. While I call myself a celiac, I actually count myself as one of those who don’t really know. If you’ve been here long enough, you know I went gluten free long before I realized there was a test for this whole thing. But between a vast improvement on a gluten free diet and the fact that my father has in fact tested positive for celiac disease, I figure I have it too. And finally, some groups are putting some research time into this. This is the first major study that I’ve seen that actually attempts to do Good Science:

Biesiekierski J. R., E. D. Newnham, P. M. Irving, J. S. Barrett, M. Haines, J. D. Doecke, S. J. Shepherd, J. G. Muir, and P. R. Gibson. 2011. Gluten Causes Gastrointestinal Symptoms in Subjects Without Celiac Disease: A Double-Blind Randomized Placebo-Controlled Trial. The American journal of gastroenterology. 1-7.

The authors had two main aims: do non-celiacs react to gluten and if so, what is/are the mechanism(s)? While there are some things that need to be worked out, we know quite a bit about celiac disease. There is modification of the gliadin portion of gluten by a molecule known as tissue transglutaminase causing them to be presented to immune cells, but only in patients who have at least one of two different genes (HLA-DQ2 or HLA-DQ8). 99.4% of patients express the gene products from one of these genes. This process results in the symptoms we see in celiac patients.

As with most good medical studies, the authors went about this by doing a double-blind, randomized, placebo-controlled trial. They took 34 people; 30 female, 4 male, ranging in age from 29-59. All reported problems that labeled them as having ‘IBS’. They responded well to a gluten free diet, but tested negative for celiac disease. 19 were placed into a gluten eating group and asked to follow their regular diet along with consuming two provided pieces of gluten containing bread and a gluten containing muffin. 15 were placed into a gluten free group and asked to follow their regular diet along with consuming two provided pieces of gluten free bread and a gluten free muffin. They were followed for 6 weeks. 56% of them had either one or both of the genes associated with celiac disease (HLA-DQ2 or HLA-DQ8).

Now, as with many medical studies, sometimes they seem to miss obvious things. The patients they recruited had to have been adhering to a gluten free diet for only 6 weeks. I don’t know about anyone else who is gluten free, but it took me much longer than 6 weeks to really get this diet. Hell, even at 8 years I still sometimes make mistakes. I think this is a major weakness of their study, despite the food diaries they asked patients to keep.

The set up was that in the 2 weeks prior to the study, patients kept a 7 day food diary. They were also asked to maintain their gluten free diet throughout the study, with 2 food diary checks in between, expect that they were to eat the two provided pieces of bread and the muffin every day for the entire 6 weeks of the study. If they were consuming the gluten containing products, this was 16g of gluten, well above the threshold for getting a response in celiac patients. Every week, and for 3 weeks after, patients symptoms were evaluated. At the beginning and end of the study serum, urine and stool were also collected for testing.

Here’s where I think things get pretty neat in a nonscience way. These researchers were crafty. To control for potential differences between gluten free and gluten containing products, they had their own muffins and breads made. The only difference between the two was that the gluten containing products had added wheat gluten. Why is this crafty? Some people have a reaction to FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols), and wheat is a food that falls under this category. So by making sure these were not present in the bread products, they ensured that they really were testing the presence of the gluten, and not any of these other compounds that might also cause symptoms not related to the gluten. And according to them, 10 normal people couldn’t tell the difference based on taste or texture between the gluten free and the gluten containing products. Crafty mofos!

Also a problem with medical studies, you don’t often get as many people as you think you need. And then some drop out. The authors estimated that they needed 30 people in each group to get good reliable statistics. But out of the 300 who applied, and the 100 that they screened, only 39 met the criteria to be included. And then 5 dropped out. Such is science.

So that leaves us 19 in the gluten group and 15 in the gluten free group. Of the 19 in the gluten group, 6 withdrew after only a week because symptoms were intolerable. 3 in the gluten free group withdrew for the same reasons after 2 weeks. Of the 19 in the gluten group, 13 (68%) reported problems on the gluten diet, while 6 of the 15 in the gluten free group reported problems (40%). While these numbers seem pretty shitty, the authors state that for the gluten eating group, even after just a week, they reported worse overall symptoms, more pain, bloating and tiredness, along with problems with their stool consistency. However, importantly, the antibodies that signify active celiac disease were not induced in either group. They also found no significant difference between those that had the celiac associated genes and those who didn’t.

Their conclusion, and one I agree with based on the study design and their data, is that non-celiac gluten sensitivity does indeed exist. While this study isn’t perfect, they have the stats to back up that 68% feeling shitty on a gluten containing diet is enough to say that there is indeed a problem. They do note, the biggest difference between the two groups was that the gluten eating group reported feeling more tired (I wonder if you can have celiac disease AND whatever this issue is, as I remember feeling incredibly tired). While they also had more problems with bloating, pain and the stool form, it was really tiredness that explained the biggest difference between the two groups.

The bad news? They have no clues as to the mechanism of the problem. C-reactive proteins, a marker for systemic immune activation, were not elevated in either group. Fecal lactoferrin levels, an indication of intestinal inflammation, were also not different between the two groups. They also measured general intestinal permeability to see if it was an issue of intestinal injury, but that too was negative. They do go into some hypotheses at the end that could explain what is happening that they did not or were not able to test for, but I don’t understand them enough to summarize here. But suffice it to say, it looks like non-celiac gluten intolerance is gaining some traction as a real medical issue.